Serum protein electrophoresis

serum protein electrophoresis

A method for determining protein 'homeostasis'; serum proteins are divided into prealbumin/albumin, α₁ and α₂, β, and γ zones; regions of the SPEP are ↑ or ↓ in certain conditions, or variable with gene polymorphisms

Serum protein electrophoresis

Fraction   Clinical conditions

Normal–6.5-8.0 g/dL 

↑ Dehydration, vomiting, diarrhea, myeloma, respiratory distress syndrome

↓ Burns, cancer–GI tract, liver disease, malnutrition, malabsorption, renal failure, ulcerative colitis

↓ Prealbumin ↓ Functional hepatic mass, inflammation, malnutrition

Albumin–4.0-6.0 g/dL 

↑ Dehydration, exercise

↓  Burns, cancer–GI tract, CHF, eclampsia, ↑ extracellular volume, inflammation, liver disease, malignancy, malnutrition, malabsorption, nephrotic syndrome, renal failure, SLE, ulcerative colitis

α₁ –0.1-0.5 g/dL 

↑ antitrypsin  Inflammation, hepatocellular injury, malignancy, pregnancy, necrosis

↓ antitrypsin  Deficient allelle causing emphysema

± antitrypsin  Polymorphism of α₁antitrypsin

α₂ –0.4-1.0 g/dL 

↑ macroglobulin Biliary cirrhosis, burns, malignancy, inflammation, acute MI, nephrotic syndrome, rheumatic fever, selective proteinuria in age extremes

↑ haptoglobulin Inflammation

↓ haptoglobulin Hemolysis, hepatosplenic sequestration, liver disease

Total β–0.3-1.2 g/dL 

β₁  

↑ transferrin Iron deficiency, estrogens

↓ transferrin Malnutrition, burns, inflammation

↓ lipoprotein  Hypercholesterolemia

±   Polymorphisms of transferrin

β₂

↑ C3  Chronic inflammation, bile obstruction

↑ IgA  Malignancy, infection of mucosal surfaces, rheumatoid arthritis, ethanol, cirrhosis

↓ C3  Complement activation

± C3  Polymorphism of C3

γ–0.4-1.0 g/dL 

↑ Collagen vascular disease, inflammation, monoclonal antibody production, polyclonal stimulation, SLE

↓ Hypogammaglobulinemia, nephrotic syndrome